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A Survey of the Status of Malaria in Guyana and Treatments: Synthetic and Herbal JPCS Vol(8) ● Jan-March 2014 www.arpapress.com/Volumes/JPCS/Vol8/JPCS_8_04.pdf A SURVEY OF THE STATUS OF MALARIA IN GUYANA AND TREATMENTS: SYNTHETIC AND HERBAL Jagessar R.C. 1* & Rampersaud E. 2 1 Senior Lecturer, Department of Chemistry, Faculty of Natural Sciences, University of Guyana 2Student, Pharmacy, Faculty of Health Sciences, University of Guyana, 2011-2012 ABSTRACT Malaria is an infectious disease characterized by recurring attacks of chills and fever, induced by the bite of an anopheles mosquito, infected with any of four protozoans of the genus Plasmodium: P. vivax, P. falciparum, P. malariae, or P. ovale). In Guyana and Worldwide, Malaria is a leading cause of infection deaths induced by vectors. It affects both the young and old, and if not taken seriously, it can prove fatal. According to the World Malaria Report 2011, by the World Health Organization (WHO), „there were 216 million cases of malaria and an estimated 655 000 deaths in 2010. Malaria mortality rates have fallen by more than 25% globally, since 2000 and by 33% in the WHO African Region. In Guyana, within the eleven year period from 2000 to 2010, the numbers of new cases of Malaria reported has shown variation with a general decrease. From the period 2000 to 2005, a general increase is noted with a maximum value of 38, 984 in 2005 from an initial value of 24,018 in 2000. A general decrease was noted from 2005 to 2010 with the number of persons infected in 2010 being 22, 935. The lowest number of 11,657 was observed in 2007. These values are significant and thus appropriate Health Standard Protocols should be followed in Guyana to curb Malaria. Both synthetic and herbal treatments are used to treat Malaria in Guyana and Globally. Keywords: Malaria, infectious disease, World Health Organisation, Plasmodium species, Ministry of Health. 1. INTRODUCTION Malaria is an infectious disease characterized by recurring attacks of chills and fever. It is induced by the bite of an anopheles mosquito which is infected with any of four protozoans of the genus Plasmodium with a characteristic life cycle1-2. The four protozoans are P. vivax, P. falciparum, P. malariae, or P. ovale 1. Malaria causes disease through a number of pathways depending on the species. Plasmodium vivax and Plasmodium falciparum are the most common, with Plasmodium falciparum, being the most deadly to the diagnostic cycles of fever which characterize malaria. Plasmodium. vivax, for example, tends to produce cycles of fever every two days, whereas Plasmodium. malaria produces fever every three. Malaria, can also be transmitted by a contaminated needle, blood transfusion, organ transplants and needle sticks3-7,8-24. With regards to the mode of action (MOA), Plasmodium falciparum infects red blood cells (RBC) and changes their structure. Infected RBC then binds to the walls of blood vessels and tissues (brain and lungs) via sequestration, allowing the malaria parasite to replicate. Infected RBC can also bind to non-infected RBCs, forming clumps of rosettes that results in the narrowing of blood vessels, leading to fatality. The formation of rosettes is mediated by the PfEMP1 protein 5. The malaria parasite is transmitted exclusively by the female anopheles mosquito3-7,8-24. The intensity of transmission depends on the condition of the environment, the human host, the vector and their breeding conditions. Anopheles mosquito‟s breed in water while each species may have their own preferences. Some may prefer shallow collections of fresh water, such as puddles, rice fields, and hoof prints. Transmission can be more intense, based on the life cycle of the mosquito, i.e. if the lifespan is longer so as to allow the complete development of the parasite in its vector and where it prefers to bite humans rather than animals. It is also dependent on the climatic conditions such as rainfall patterns, temperature and humidity, as it may affect the number and survival of the mosquitoes. In many places, transmission is seasonal, with the peak during and just after the rainy season. Malaria epidemics can occur when climate and other conditions suddenly favour transmission in areas where people have little or no immunity to malaria. They can also occur when people with low immunity move into areas with intense malaria transmission, for instance to find work, or as refugees. In Guyana, malaria is prevalent in the interiors since many residents often go there, seeking job opportunities. Many natives residing there are also affected as they are out of reach due to lack of electricity and telephone lines as a way of educating their population . Symptoms of malaria include: Fever, Headache, Chills, Vomiting, Muscle aches, Diarrhea, Coughing, Sweating, Enlarged spleen. Infection by Plasmodium falciparum, if not treated immediately can lead to severe illness and often 26 JPCS Vol(8) ● Jan-March 2014 Jagessar Rampersaud ● A Survey of the Status of Malaria in Guyana” results in death6. Sign and symptoms of infection by this species include: Bleeding problems, Shock, Liver or kidney failure, Central nervous System problems, Coma, Cerebral malaria (coma, or altered mental status or seizures, anemia.There are three types of malarial fever based on symptoms and the organism causing the attack. These include: Tertian Fever, Quartan Fever, Malignant Fever. Malaria is referred to as an „acute febrile illness.‟ In a normal, unsuspecting, non immune individual, symptoms appear seven days or more (usually 10–15 days) after the infective mosquito bite. Researchers and scientists around the world have not yet established an effective vaccine to control the spread of malaria but7. However, several are under development. Glaxo Smith Kline, a renowned pharmaceutical manufacturer, has proven to half the risk of African children from getting malaria during the clinical trial of what is likely to become the world‟s first vaccine against the disease. Scientists stressed that the vaccine known as RTS,S or Mosquirix, is no quick fix for eradicating the disease and is no less effective against it than other vaccines are against common infections such as polio and measles7-8. Recently, it has been shown that Heparin modified atomic force microscope (AFM) tip binds specifically to infected red blood cells through interaction with the PfEMP1 protein, but not to uninfected cells. Haparin is a very strong candidate for malaria treatment because it has anti-malaria activity by itself. It also has specific targeting abilities and a strong interaction with plasmodium infected red blood cell. Heparin could be used to carry more potent antimalarials to their target sites5. In Guyana, malaria affects both old and young and if appropriate measures are not taken, the disease can be fatal. This paper describes the status of malaria in Guyana and its treatment via synthetic and herbal means. Procedure: (a) Sample collection: Statistical data for malaria between the period 2000 to 2010 were collected from the Ministry of Health and were analysed26-28. Results: The following results were obtained from the Georgetown Public hospital from the period of 2000 to 2010. Table showing average cases of malaria per year within eleven years Year 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Average, X Numb 24018 27122 21872 27627 28866 3898 2106 1165 11815 13673 22935 226 93.91 er. of 4 4 7 New ± 8210.30 Cases The Standard Deviation (SD), Variance and Confidence Limit (CL)9-12 was found to be ± 8210.30, 67409026.09 and CL (µ)= 22693.90909 ± 4851.977241 and respectively. 27 JPCS Vol(8) ● Jan-March 2014 Jagessar Rampersaud ● A Survey of the Status of Malaria in Guyana” Fig.1.0. Bar chart showing the number of persons infected with malaria per year in Guyana Between the year 2000 to 2010 (Courtesy of the Georgetown Public Hospital, GPH, 2012) 28 JPCS Vol(8) ● Jan-March 2014 Jagessar Rampersaud ● A Survey of the Status of Malaria in Guyana” Map of Guyana showing Status of Malaria induced by Plasmodium Falciparum in 2010 29 JPCS Vol(8) ● Jan-March 2014 Jagessar Rampersaud ● A Survey of the Status of Malaria in Guyana” 2. DISCUSSION The data above shows the number of persons infected with malaria over the period 2000 to 2010. The year 2000 register 24,018 malaria cases and this increased to 27122 in 2001. A decline was noted in 2002. From 2003 to 2005, there was a significant increase with the highest value of $38,984 been registered in 2005. This high increase in 2005 was probably due to one of the largest floods in Guyana‟s history. Many water borne diseases were rampant. It was an opportunity for mosquitoes of all species to multiply. Malaria was one of the vector diseases that were noticeably on the increase. There was a decline in 2006 to 2008, with the lowest value of 11, 815 been recorded in 2008. This general decrease was probably due to the drastic measures undertaken by the government of Guyana to combat malaria. After the flood, the next year there was a significant decrease in the number of new cases reported. This was due to proper control of the vector. The government of Guyana through its Ministry of Health has resorted to promoting education of their citizens about malaria. They distributed insecticide impregnated nets especially in the interiors where malaria is prominent, which may have lead to a decrease. Again, from the period 2009 to 2010. Values was 13,673 and 22,935 respectively. The average number of persons infected with malaria within the eleven year period is calculated to be 22,693.90909 with a standard deviation of 22693.90909 ± 8210.30 and variance of 67409026.09. The confidence interval (CI) was calculated to be 22693.90909 ± 4851.977241.
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